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A Case Study of Narrative Family Therapy in an Outdoor Treatment Program with a Struggling Adolescent

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Book cover Family Therapy with Adolescents in Residential Treatment

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Abstract

Adolescent mental health is a significant societal concern with 10–20% of adolescents meeting criteria for a diagnosable mental disorder. Adolescent mental health disorders are concerning as they interfere with the accomplishment of normal development and can lead to poor school performance, dropout, strained family and social relationships, involvement with the child welfare and juvenile justice system , and other disruptive behaviors . Adolescents who do not respond to traditional services are often placed in residential treatment centers or other out-of-home treatment programs. Outdoor Behavioral Healthcare (OBH) is a viable treatment option for adolescents who struggle with emotional, behavioral or substance related problems, and one which flexibly permits an integration of the family into the treatment setting. A case study illustrating how techniques from narrative can be used to accomplish this integration is presented in this chapter, offering a view of how narrative family therapy can be used to involve families in the treatment and posttreatment process in an OBH program.

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References

  • Anderson, N.B. (2006). Evidence-based practice in psychology. American Psychologist61(4), 271–285. doi:10.1037/0735-7028.39.6.658

  • Association of Experiential Education. (2015). Accreditation for outdoor behavioral healthcare programs. Retrieved from: http://www.aee.org/accreditation-for-outdoor-behav-health

  • Becker, S. P. (2010). Wilderness therapy: Ethical considerations for mental health professionals. Child & Youth Care Forum, 39(1), 47–61. doi:10.1007/s10566-009-9085-7

  • Belfer, M. L. (2008). Child and adolescent mental disorders: The magnitude of the problem across the globe. Journal of Child Psychology and Psychiatry, 49(3), 226–236. doi:10.1111/j.1469-7610.2007.01855.x

  • Bettmann, J. E., Russell, K. C., & Parry, K. J. (2012). How substance abuse recovery skills, readiness to change and symptom reduction impact change processes in wilderness therapy participants. Journal of Child and Family Studies, 22(8), 1039–1050. doi:10.1007/s10826-012-9665-2

  • Bray, B. (2014). Going wild. Counseling Today. Retrieved from: http://ct.counseling.org/2014/12/going-wild/

  • Brown, D. W., Anda, R. F., Tiemeier, H., Felitti, V. J., Edwards, V. J., Croft, J. B., et al. (2009). Adverse childhood experiences and the risk of premature mortality. American Journal of Preventive Medicine, 37(5), 389–396. doi:10.1016/j.amepre.2009.06.021

  • Carr, A. (1998). Michael White’s narrative therapy. Contemporary Family Therapy, 20(4), 485–503.

    Article  Google Scholar 

  • Cason, D., & Gillis, H. L. (1994). A meta-analysis of outdoor adventure programming with adolescents. Journal of Experiential Education, 17, 40–47.

    Article  Google Scholar 

  • Christenson, J. D., & Miller, A. L. (2016). Slowing down the conversation: The use of letter writing with adolescents and young adults in residential settings. Contemporary Family Therapy, 38(1), 23–31.

    Article  Google Scholar 

  • Clark, J., Marmol, L. M., Cooley, R., & Gathercoal, K. (2004). The effects of wilderness therapy on the clinical concerns (on Axes I, II, and IV) of troubled adolescents. Journal of Experiential Education, 27(2), 213–232. doi:10.1177/105382590402700207

  • Cottrell, D., & Boston, P. (2002). Practitioner review: The effectiveness of systemic family therapy for children and adolescents. Journal of Child Psychology and Psychiatry43(5), 573–586. doi:10.1111/1469-7610.00047

  • DeAngelis, T. (2013). Therapy gone wild. Monitor on Pscyhology, 44(8), 48–53.

    Google Scholar 

  • DeMille, S. M. (2015). Do therapeutic factors and client gender impact treatment outcomes for adolescents participating in outdoor behavioral healthcare treatment? (Doctoral dissertation). Minneapolis, MN: Capella University.

    Google Scholar 

  • DeMille, S. M., & Burdick, M. (2015). A theoretically anchored and multi-modal treatment approach in an outdoor behavioral healthcare program. Journal of Therapeutic Schools & Programs, 7(1), 19–30.

    Google Scholar 

  • DeMille, S. M., Comart, C., & Tucker, A. R. (2014). Body composition changes in an outdoor behavioral healthcare program. Ecopsychology, 6(3), 174–182. doi:10.1089/eco.2014.0012

  • DeMille, S. M., & Montgomery, M. (2016). Integrating narrative family therapy in an outdoor behavioral healthcare program: A case study. Contemporary Family Therapy, 38(1), 3–13. doi:10.1007/s10591-015-9362-6

  • Diamond, G. S., Serrano, A. C., Dickey, M., & Sonis, W. A. (1996). Current status of family-based outcome and process research. Journal of the American Academy of Child & Adolescent Psychiatry35(1), 6–16. doi:10.1097/00004583-199601000-00007

  • Epston, D., & White, M. (1992). Experience, contradiction, narrative and imagination. Adelaida: Dulwich Centre Publication.

    Google Scholar 

  • Faddis, T. J., & Bettmann, J. E. (2010). Reflecting teams and other innovative family therapy techniques adapted for outdoor behavioral healthcare. Journal of Therapeutic Schools and Programs, 1(1), 57–69.

    Google Scholar 

  • Faddis, T. J., & Cobb, K. F. (2016). Family therapy techniques in residential settings: Family sculptures and reflecting teams. Contemporary Family Therapy, 38(1), 43–51.

    Article  Google Scholar 

  • Fauber, R. L., & Long, N. (1991). Children in context: The role of the family in child psychotherapy. Journal of Consulting and Clinical Psychology59(6), 813–820. doi:http://dx.doi.org.library.capella.edu/10.1037/0022-006X.59.6.813

  • Freedman, J., & Combs, G. (1996). Narrative therapy: The social construction of preferred realities. New York: Norton.

    Google Scholar 

  • Gass, M., Logan, P., Christensen, N., Hallows, G., Liebing, M., Smith, P. … Tierney, S. (2014). Manual of accreditation standards for outdoor behavioral healthcare programs (1st ed.). Boulder, CO: Association of Experiential Education.

    Google Scholar 

  • Gillis, H. L., & Gass, M. A. (2010). Treating juveniles in a sex offender program using adventure-based programming: A matched group design. Journal of Child Sexual Abuse, 19(1), 20–34.

    Google Scholar 

  • Hair, H. J. (2005). Outcomes for children and adolescents after residential treatment: A review of research from 1993 to 2003. Journal of Child and Family Studies14(4), 551–575. doi:10.1007/s10826-005-7188-9

  • Harper, N. J., & Russell, K. C. (2008). Family involvement and outcome in adolescent wilderness treatment: A mixed-methods evaluation. International Journal of Child & Family Welfare, 1, 19–36.

    Google Scholar 

  • Harper, N. J., Russell, K. C., Cooley, R., & Cupples, J. (2007). Catherine Freer wilderness therapy expeditions: An exploratory case study of adolescent wilderness therapy, family functioning, and the maintenance of change. Child and Youth Care Forum, 36(2–3), 111–129. doi:10.1007/s10566-007-9035-1

  • Jones, C. D., Lowe, L. A., & Risler, E. A. (2004). The effectiveness of wilderness adventure therapy programs for young people involved in the juvenile justice system. Residential Treatment for Children & Youth, 22(2), 53–67.

    Article  Google Scholar 

  • Kieling, C., Baker-Henningham, H., Belfer, M., Conti, G., Ertem, I., Omigbodun, O. … Rahman, A. (2011). Child and adolescent mental health worldwide: Evidence for action. The Lancet, 378(9801), 1515–1525.

    Google Scholar 

  • Lambie, I., Hickling, L., Seymour, F., Simmonds, L., Robson, M., & Houlahan, C. (2000). Using wilderness therapy in treating adolescent sexual offenders. The Journal of Sexual Aggression, 5(2), 99–117. doi:10.1080/13552600008413302

  • Leichtman, M., Leichtman, M. L., Barber, C. C., & Neese, D. T. (2001). Effectiveness of intensive short-term residential treatment with severely disturbed adolescents. American Journal of Orthopsychiatry71(2), 227. doi:10.1037/0002-9432.71.2.227

  • Lewis, S. F. (2013). Examining changes in substance use and conduct problems among treatment‐seeking adolescents. Child and Adolescent Mental Health, 18(1), 33–38. doi:10.1111/j.1475-3588.2012.00657.x

  • Magle-Haberek, N., Tucker, A., & Gass, M. (2012). The effects of program differences within wilderness therapy and residential treatment center (RTC) programs. Residential Treatment for Children and Youth, 29(3), 202–218. doi:10.1080/0886571X.2012.697433

  • Marion, J. L., & Reid, S. E. (2007). Minimising visitor impacts to protected areas: The efficacy of low impact education programmes. Journal of Sustainable Tourism15(1), 5–27. doi:10.2167/jost593.0

  • McLeod, J. (2010). The role of case studies in the development of theory and practice in counselling and psychotherapy. In J McLeods (Ed.), Case study research: In counselling and psychotherapy (pp. 1–15). London: SAGE Publications Ltd.

    Google Scholar 

  • Minuchin, S. (1998). Where is the family in narrative family therapy? Journal of Marital and Family Therapy, 24(4), 397–403.

    Article  PubMed  Google Scholar 

  • National Building Bridges Initiative. (2007). Innovative practices for transformation. Workgroup webinar.

    Google Scholar 

  • Norton, C. L. (2008). Understanding the impact of wilderness therapy on adolescent depression and psychosocial development. Illinois Child Welfare, 4(1), 166–178.

    Google Scholar 

  • Norton, C. L. (2010a). Exploring the process of a therapeutic wilderness experience: Key therapeutic components in the treatment of adolescent depression and psychosocial development. Journal of Therapeutic School and Program, 4(1), 24–46.

    Google Scholar 

  • Norton, C. L. (2010b). Into the wilderness—A case study: The psychodynamics of adolescent depression and the need for a holistic intervention. Clinical Social Work Journal, 38(2), 226–235. doi:10.1007/s10615-009-0205-5

  • O’Connell, M. E., Boat, T., & Warner, K. E. (Eds.). (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Washington DC: National Academies Press.

    Google Scholar 

  • O’Connor, T. S. J., Meakes, E., Pickering, M. R., & Schuman, M. (1997). On the right track: Client experience of narrative therapy. Contemporary Family Therapy, 19(4), 479–495.

    Article  Google Scholar 

  • Outdoor Behavioral Healthcare Council. (OBHC, 2015). About Us. Retrieved from: https://obhcouncil.com/about/standards/

  • RedCliff Ascent. (2015). Who do we serve? The Wilderness Advisor, 1, 7–8.

    Google Scholar 

  • Riordan, R. J. (1996). Scriptotherapy: Therapeutic writing as a counseling adjunct. Journal of Counseling & Development, 74(3), 263–269.

    Article  Google Scholar 

  • Russell, K. C. (2006). Evaluating the effects of the Wendigo Lake Expedition Program on young offenders. Youth Violence and Juvenile Justice, 4(2), 185–203.

    Google Scholar 

  • Russell, K. C., & Gillis, H. L. (2010). Experiential therapy in the mental health treatment of adolescents. Journal of Therapeutic Schools and Programs, 4(1), 47–79.

    Google Scholar 

  • Russell, K., & Hendee, J. (2000). Definition, common practice, expected outcomes, and a nationwide survey of programs (Technical Report 26). Moscow, ID: University of Idaho.

    Google Scholar 

  • Russell, K. C. (2003). Assessing treatment outcomes in outdoor behavioral healthcare using the Youth Outcome Questionnaire. Child and Youth Care Forum. 32, 355–381. doi:10.1023/B:CCAR.0000004507.12946.7e

  • Russell, K. C. (2005a). Preliminary results of a study examining the effects of outdoor behavioral healthcare treatment on levels of depression and substance use frequency. Journal of Experiential Education, 27, 305–307.

    Google Scholar 

  • Russell, K. C. (2005b). Two years later: A qualitative assessment of youth-well-being and the role of aftercare in outdoor behavioral healthcare treatment. Child and Youth Care Forum, 34, 209–239. doi:10.1007/s10566-005-3470-7

  • Russell, K. C. (2008). Adolescent substance-use treatment: Service delivery, research on effectiveness, and emerging treatment alternatives. Journal of Groups in Addiction & Recovery, 2(2–4), 68–96. doi:10.1080/15560350802081264

  • Russell, K. C. & Farnum, J. (2004). A concurrent model of the wilderness therapy process. Journal of Adventure Education and Outdoor Learning4, 39–55. doi:10.1080/14729670485200411

  • Russell, K. C., Gillis, H. L., & Lewis T. G. (2008). A five-year follow-up of a survey of North American outdoor behavioral healthcare programs. Journal of Experiential Education, 31(1), 55–77. doi:10.1177/105382590803100106

  • Russell, K. C., & Sibthorp, J. (2004). Hierarchical linear modeling of treatment outcomes in outdoor behavioral healthcare. Journal of Experiential Education, 27, 176–191.

    Article  Google Scholar 

  • Safran, J. D., Muran, J. C., & Proskurov, B. (2009). Alliance, negotiation, and rupture resolution. In R. Levy & S. J. Ablon (Eds.), Handbook of evidence based psychodynamic psychotherapy (pp. 201–205). New York: Humana Press.

    Chapter  Google Scholar 

  • Substance Abuse and Mental Health Services Administration. (2012). National survey on drug use and health: Mental health findings. Rockville, MD: Substance Abuse and Mental Health Services Administration.

    Google Scholar 

  • Stage, S. A. (1998). Predicting adolescents’ discharge status following residential treatment. Residential Treatment for Children & Youth16(3), 37–56. doi:10.1300/J007v16n03_03

  • Telep, T. (2014). The man who takes troubled youths to therapy camp. BBC News Magazine. Retrieved from: http://www.bbc.com/news/magazine-26513805

  • Tubman, J. G., Montgomery, M. J., & Wagner, E. F. (2001). Letter writing as a tool to increase client motivation to change: Application to an inpatient crisis unit. Journal of Mental Health Counseling, 23(4), 295–311.

    Google Scholar 

  • Tucker, A., Norton, C. L., DeMille, S. M., & Hobson, J. (2016). The impact of wilderness therapy. Journal of Experiential Education, 39(1), 15–30. doi:10.1177/1053825915607536

  • Tucker, A., Smith, A., & Gass, M. (2014). The impact of presenting problems and individual client characteristics on treatment outcomes in residential and wilderness treatment programs. Residential Treatment for Children and Youth, 31(2), 135–153.

    Article  Google Scholar 

  • Tucker, A. R., Zelov, R., & Young, M. (2011). Four years along: Emerging traits of programs in the NATSAP practice research network (PRN). Journal of Therapeutic Schools and Programs, 5(1), 10–28.

    Google Scholar 

  • Walsh, V., & Golins, G. (1976). The exploration of the outward bound process. Denver, CO: Outward Bound School.

    Google Scholar 

  • White, M. (1989). Select papers. Adelaide: Dulwich Centre Publications.

    Google Scholar 

  • White, N. W. (2011). Stories from the elders: Chronicles and narratives of the early years of wilderness therapy. Franklin Pierce University.

    Google Scholar 

  • Wright, A. (1983). Therapeutic potential of the outward bound process: An evaluation of a treatment program for juvenile delinquents. Therapeutic Recreation Journal, 17(2), 33–42.

    Google Scholar 

  • Zelov, R., Tucker, A. R., & Javorksi, S. (2013). A new phase for the NATSAP PRN: Post-discharge reporting and transition to the network wide utilization of the Y-OQ 2.0. Journal of Therapeutic Schools & Programs, 6(1), 7–19.

    Google Scholar 

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Correspondence to Steven M. DeMille .

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DeMille, S.M., Montgomery, M.J. (2017). A Case Study of Narrative Family Therapy in an Outdoor Treatment Program with a Struggling Adolescent. In: Christenson, J., Merritts, A. (eds) Family Therapy with Adolescents in Residential Treatment. Focused Issues in Family Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-51747-6_3

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